Fillable ATTACHMENT FM-1052 SUPERIOR COURT OF CALIFORNIA, COUNTY OF (The Superior Court of California, County of Santa Clara)

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ATTACHMENT FM-1052 SUPERIOR COURT OF CALIFORNIA, COUNTY OF (The Superior Court of California, County of Santa Clara)

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ATTACHMENT FM-1052
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
FOR COURT USE ONLY
FAMILY LAW JUDGMENT CHECKLIST
DISSOLUTION (DIVORCE), LEGAL SEPARATION AND
DOMESTIC PARTNERSHIP
CASE NUMBER:
Attorney/Mediator Self-Represented Party
INSTRUCTIONS:
Use this checklist to show the Court that you have turned in all the forms needed to get a Judgment in your case.
There are four types of cases:
1. True Default - no Response filed, no written agreement
2. Status only Judgment - termination of marriage is the only issue
3. Default case with written agreement - no Response filed
4. Uncontested - appearance by both parties and a written agreement.
Check the box below for your type of case (one of the four listed above). Then complete all the items in that
checklist. You only need to complete the checklist for your case type. All items must be completed either by
checking each line to indicate you have filed that form or by marking “N/A” to say that an item is not applicable.
Submit an additional copy of page 1 of the Judgment.
So that we can get your forms back to you, please turn in an envelope that is addressed to you, is large enough
and has enough postage. If you do not want your forms mailed, give us other instructions.
TRUE DEFAULT CASE (no response filed and NO WRITTEN AGREEMENT between the parties)
1. Proof of Service of Summons [FL-115] (check one of the following):
Personal Service [FL-115]
Notice and Acknowledgment of Receipt attached [FL-117]
Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]
Other, (please describe)
2.
Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid
Income and Expense Declaration [FL-150]
(if you are requesting spousal support or attorney fees/costs)
Financial Statement (simplified) [FL-155]
(if you have a minor child, you are
not requesting spousal support or attorney fees/costs, and you
qualify for this form according to the instructions on page 2 of the form; if you have a minor child and
you do not qualify, you must complete an Income and Expense Declaration)
Property Declaration [FL-160]
(if you have requested any property in your petition)
FM-1052 REV 1/01/13
FAMILY LAW JUDGMENT CHECKLIST Page 1 of 4
Dissolution (Divorce), Legal Separation and Domestic Partnership
To keep other people from
seeing what you have
entered, please press the
Reset Form button at the end
of this form when finished.
ATTACHMENT FM-1052
FM-1052 REV 1/01/13
FAMILY LAW JUDGMENT CHECKLIST Page 2 of 4
Dissolution (Divorce), Legal Separation and Domestic Partnership
3.
Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]
4. Declaration Regarding Service of Petitioner’s (Preliminary) Declaration of Disclosure [FL-141] (submit
endorsed-filed copy if previously filed)
5.
Declaration Regarding Service of Petitioner’s (Final) Declaration of Disclosure or Waiver of Final
Declaration of Disclosure [FL-141]
6.
Judgment [FL-180]
(You must request that spousal support be ordered, terminated or reserved for both parties)
If you are requesting property division include Property Order Attachment [FL-345]
7. The marriage/partnership is over 10 years in duration, or termination of spousal/partner support for the
respondent is requested, include:
Spousal or Partnership Support Declaration Attachment [FL-157]
Current Income & Expense Declaration [FL-150]
Spousal, Partner, or Family Support Order Attachment [FL-343] or other proposed written order (attach to
Judgment)
8. If there are minor children in the case attach a:
Child Custody and Visitation Attachment [FL-341]
Child Support Order Attachment [FL-342]
Guideline Child Support Calculation (Judicial Council approved software)
Non-Guideline Child Support Findings Attachment [FL-342(A)]
Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]
Child Support Case Registry Form [FL-191]
Order/Notice to Withhold Income [FL-195]
9.
Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)
10. Other (Identify any optional form included):
STATUS ONLY JUDGMENT (Termination of marriage is the only issue addressed)
1. Proof of Service of Summons [FL-115] (check one of the following):
Personal Service [FL-115]
Notice and Acknowledgment of Receipt attached [FL-117]
Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]
Other, (please describe)
2. Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid
Income and Expense Declaration [FL-150]
(If you are requesting spousal support or attorney fees/costs)
Financial Statement (simplified) [FL-155]
(if you have a minor child, you are
not requesting spousal support or attorney fees/costs, and you
qualify for this form according to the instructions on page 2 of the form; if you have a minor child and
you do not qualify, you must complete an Income Expense Declaration)
Property Declaration [FL-160]
(If you have requested any property in your Petition)
ATTACHMENT FM-1052
FM-1052 REV 1/01/13
FAMILY LAW JUDGMENT CHECKLIST Page 3 of 4
Dissolution (Divorce), Legal Separation and Domestic Partnership
3.
Appearance, Stipulation, and Waivers [FL-130] (if Response was filed)
4. Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]
5.
Declaration Regarding Service of Petitioner’s (Preliminary) Declaration of Disclosure [FL-141]
Also need Respondent’s Declaration if a Response was filed.
6.
Stipulation and/or Order for Bifurcation (pleading form)
7.
Judgment [FL-180], with the Bifurcation of Status of Marriage or Domestic Partnership [FL-347] attached
8.
Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)
9.
If either party has a retirement plan (if you do not check this box, you are certifying that neither party has
a retirement plan)
All retirement plans must be joined to the proceeding pursuant to Family Code §2337(d)(1), AND
The Status-Only Judgment includes an order disposing of each party’s interest in retirement plans
benefits, including survivor or death benefits, OR
The Status-Only Judgment includes an interim order [on FL-347] preserving the nonemployee party’s
right to retirement plan benefits, including survivor and death benefits, pending entry of judgment on
all remaining issues, OR
The Status-Only Judgment includes the Pension Benefits – Attachment to Judgment [FL-348]
DEFAULT CASE WITH WRITTEN AGREEMENT (no response filed)
1.
Proof of Service of Summons [FL-115] (check one of the following):
Personal Service [FL-115]
Notice and Acknowledgment of Receipt attached [FL-117]
Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]
Other (please describe)
2.
Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid
Income and Expense Declaration [FL-150]
(if you are requesting spousal support or attorney fees/costs)
Financial Statement (simplified) [FL-155]
(if you have a minor child, you are
not requesting spousal support or attorney fees/costs, and you
qualify for this form according to the instructions on page 2 of the form; if you have a minor child and
you do not qualify, you must complete an Income Expense Declaration)
Property Declaration [FL-160]
(if you have requested any property in your petition)
Written Agreement
3.
Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]
4.
Declaration Regarding Service of Petitioner’s and Respondent’s (Preliminary) Declaration of Disclosure
[FL-141]
5.
Declaration Regarding Service of Petitioner’s and Respondent’s (Final) Declaration of Disclosure [FL-141]
or Waiver of Final Declaration of Disclosure [FL-144]
6.
Judgment [FL-180] with written agreement
(must address issues regarding spousal support and property division)
Signature(s) are notarized for self-represented parties
Attorney has signed and approved Judgment for represented party
ATTACHMENT FM-1052
FM-1052 REV 1/01/13
FAMILY LAW JUDGMENT CHECKLIST Page 4 of 4
Dissolution (Divorce), Legal Separation and Domestic Partnership
6a. If there are minor children:
Child Support - State whether child support is at guideline amount or not and include language
required in Family Code §4065
If below guideline, attach guideline support calculation (Judicial Council approved software)
Medical insurance and uninsured health care costs addressed
Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]
Child Support Case Registry Form [FL-191]
Order/Notice to Withhold Income [FL-195]
7. Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)
UNCONTESTED CASE (Response or Appearance, Stipulation and Waivers filed by Respondent and a
written agreement)
1.
Appearance, Stipulations, and Waivers [FL-130] (along with Respondent’s first appearance fee if not
already paid)
2.
Declaration for Default or Uncontested Dissolution/Legal Separation [FL-170]
3.
Declaration Regarding Service of Petitioner’s and Respondent’s (Preliminary) Declaration of Disclosure
[FL-141]
4. Declaration Regarding Service of Petitioner’s and Respondent’s (Final) Declaration of Disclosure [FL-141]
or Waiver of Final Declaration of Disclosure [FL-144]
5.
Judgment [FL-180] with written agreement
(Spousal support and property division issues are addressed)
Signature(s) are notarized for self-represented parties
Attorney has signed and approved Judgment for represented party
5a. If there are minor children:
Child custody/visitation and Family Code §3048 issues are addressed
Child Support - State whether child support is at guideline amount or not and include language
required in Family Code §4065
If below guideline, attach guideline support calculation (Judicial Council approved software)
Medical insurance and uninsured health care costs addressed
Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]
Child Support Case Registry Form [FL-191]
Order/Notice to Withhold Income [FL-195]
6.
Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)
I certify that all of the information indicated in this checklist has been provided to the court.
Date:
Submitting party’s signature
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ATTACHMENT FM-1052 SUPERIOR COURT OF CALIFORNIA, COUNTY OF (The Superior Court of California, County of Santa Clara)

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Completed 23 May 2022

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